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Heart health vastly different from state to state


Americans’ cardiovascular health varies greatly from state to state, according to a study that is said to be the first to assess cardiovascular health at the state level.

“Since the Centers for Disease Control and Prevention is funding state heart disease and stroke prevention programs, we thought it would be helpful to have cardiovascular health information on the state level to help better focus our efforts,” Jing Fang, MD, MS, an epidemiologist with the CDC’s Division for Heart Disease and Stroke Prevention in Atlanta, said in a news release.

Using 2009 data from the Behavioral Risk Factor Surveillance System — a telephone survey of more than 350,000 people in the 50 states and Washington, D.C. — researchers collected information on the American Heart Association’s seven major heart-health factors: blood pressure, total cholesterol, smoking, body mass index, diabetes, physical activity and fruit and vegetable consumption.

The researchers found that the percentage of the population reporting ideal cardiovascular health, as defined by having optimal levels of all seven factors, was lowest in Oklahoma, West Virginia and Mississippi and highest in Vermont, Virginia and Washington, D.C. In general, people living in western states and New England reported having a higher percentage of ideal cardiovascular health.

About 3% of the total U.S. population reported having ideal heart health. About 10% reported having poor cardiovascular health, as defined by having two or fewer heart-health factors at optimal levels.

Fang said on average, Americans reported having more than four of the seven risk factors for heart disease, and the researchers found large disparities by age, sex, race/ethnicity and levels of education.

The lowest percentage of ideal heart health was among people ages 65 and older, while the highest was among the 35-to-54 age group. Women fared better than men in the survey, while whites and Asian/Pacific Islanders reported the highest rates of heart health and blacks, Native Americans and Alaska Natives reported the lowest. Those in the highest education group reported better heart health overall than people in groups with lower levels of education.

Estimates in the report could help those charged with preventing heart disease and stroke set statewide goals for reducing risk and improving cardiovascular health. “The comparisons offered by Fang and colleagues illustrate a critical point: Cardiovascular health status in the United States varies considerably by age, sex, race/ethnicity and education as well as by state,” said Donna Arnett, PhD, president of the American Heart Association and author of an editorial that accompanies the study.

“This diversity necessitates that innovative, customized strategies be developed to most effectively improve cardiovascular health for specific states and among subpopulations.”

The study appears in the December issue of the Journal of the American Heart Association and is available at


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